How I Managed Anxiety in PA School

Imagine: You’re out to dinner with friends feeling nothing out of the ‘norm’, in a comfortable environment…and within a matter of minutes you’re attempting to convince friends to call 911 from the rush of the ‘impending doom’ feeling that just flooded your body, paired with a constrictive sub-sternal chest pain… you’re completely soaked in sweat, tingling hands & feet that result in numbness, and blacked out vision. You sit there – you close your eyes. You regain your breath & symptoms subside. Aside from the ringing in your ears & a residual tight airway – you feel relieved. You look across the table at the concerned friends & you ask yourself “Wtf just happened”… ”Is that going to happen again?”… “What’s wrong with me?”

This was my first panic attack. And it wasn’t my last… 

How it started: In undergrad during my junior year I was CONVINCED I had a learning disorder. Studying took me 5xs the amount of time to review material and retain the information than the time it would cost my cohorts. All of this despite my very strict self-control to stay inside refreshing on material every night. Each night I would stay up in the library just to stay on par with the best grade I could receive, while friends I had were out having fun or at home watching TV together. Regardless of my efforts, my grades weren’t straight A’s …or at times even B’s. This frustration lead me to seek out the university psychologist who politely listened to my concerns, we discussed my fear of failure, & decided to proceed to undergo testing to find the root cause of this “problem”. The testing consisted of 4 months of IQ tests, a variety of psycho-educational tests, and personality tests combined with individual counseling sessions to find the origin.
At the end of the 4 months of testing, I was absolutely terrified that maybe I was dyslexic like others in my family had been, or maybe I just had a low IQ? Guys, I dreaded the final feedback appointment to discuss my results.
Results came back stating I didn’t have a low IQ, I wasn’t dyslexic, but I was in the 95th percentile for ADHD and the 99th for General Anxiety Disorder (GAD) among those my age and educational level.
My therapist educated me on what treatment options looked like for this, different strategies to overcome thoughts, and recommended I continue individual counseling to sort through my thoughts and to improve my self-confidence regarding my self-image and perception of my intelligence. I continued the counseling until I graduated with my undergrad degree and found many benefits through these therapy sessions with my counselor for my mental clarity. 
Fast FWD to PA School: I clearly remember it was first week of didactic, sitting in a coffee shop trying to figure out a game plan to the ungodly amount of material that was just dumped on us & how to manage everything at once. 
The best piece of advice I received from a friend of mine in that crazy fiasco of a time: Just take one thing at a time. I mean, sounds pretty simple & cliché – I hear you. But I quickly realized that I by being so overwhelmed by the load of material that nothing was getting accomplished & the ONLY way to tackle it all in an effective manner was to quite literally just focus on one thing until you can move on to the next. 
So, back to my anxiety…. 

How I struggled: My anxiety was always rooted by the stressor of wanting to do well (just like many of you) & accompanied by the fear of failure. For many years it was easy to float by, get assignments done, be a well-rounded person, etc. I never once had the fear that maybe this wasn’t the right career choice for me and that was my driving force to push myself. But this driving force manifested as a double edge sword as I would work myself to extreme limits that were not healthy; I dropped weight, forgot to eat, wasn’t resting at night, and had major anxiety about my performance throughout didactic. Oh, and to top the cake of being a complete ball of anxiety for the first portion of PA school…I also had insane test anxiety resulting in doubting myself on material that I pounded in my head for hours prior. 

Anxiety can be a frightening downward spiral if you don’t address it & the unnecessary burden it places on your every day

This blog simply conveys my past obstacles, those I learn to hurdle still, and how I’ll tackle those I face in the future. Diving in a bit deeper than my Instagram highlights may portray my life to be. Remember that this is in no way medical advice & the following is just a few ways that have helped me manage my life with more anxiety than your average. 

 Looking back at how I got ahold of these emotions & thoughts that would exhaust me before I sought help from my provider with the best plan for me…the following changes helped me learn to manage a particularly rough season in my life: 
How I overcame anxiety from school stressors:

1.    Pause & Analyze your Present Situation: Where am I right now? Identify whatever I may be feeling whether that means acknowledging that I’m anxious, nervous, scared, grumpy, hangry (happens to the best of us). From here I test things that help remove me from these places and/or situations that make me feel overwhelmed. Not acknowledging the present will only leave you spiraling deeper and deeper- break the thought loop you get stuck in. 

2.    Strategize & Remember the Bigger Picture- Because it’s easy to move into that downward spiral, you need a plan to break out of it when it occurs. When racing / intense thoughts or fear creep in, you need to plan ahead of time for what you’ll do to snap out of it. Turning feelings of anxiety into something recognizable enough to reverse before being affected by it has been quite a skill I’ve worked hard to attain. For me, I take myself out of the situation and ask myself literalquestions without tying the truth of the result to an outcome I have potentially and/or unrealistically assumed. 
WHAT am I feeling?
WHY do I feel this way? 
WHAT can I do about it RIGHT NOW?
IS THE OUTCOME within my control? 
WHY am I letting this particular feeling take priority & what next step can I do to change it?

More times than I can count in PA school I would detach myself from the situation that would be momentarily frustrating me or really causing me to struggle. I would remind myself that no one has forced me to be hereI CHOSE PA schoolI wanted it more than ANYTHING & I would go through ANYTHING to make it out successfully

It was all MY DECISION.

I would literally remind myself (often) that I wouldn’t have been offered a seat in my program if it wasn’t possible to complete – in fact, at some point others willingly offered me a seat because they believed in me, too! All PA school curriculums are DESIGNED to be rigorous. This shift in perspective gave me the attitude I needed to feel confident enough to turn my back to feelings of defeat when my best didn’t seem ‘good enough’ at times.

3.    Organizing your time: Time management is HUGE in relieving anxious thoughts.  The majority of the time anxiety is a result of not having enough time to accomplish everything or overthinking unrealistic scenarios. By letting thoughts run wild leads to a severely diminished level of productivity –so, to stop this cycle of events I learned to utilize days by maximizing the time spent in each area of where I spent my time and to be fully present in whatever that was. So the feeling of “wasting time”, wasn’t an added stressor. 
& most importantly, learning to apply this technique to study habits—adding organization and study goals that are manageable to tackle one by one. This can be done by breaking down the material into practical tasks and start using a calendar to write down everything that needs to be accomplished by certain dates.
The workload in PA School will never change or lighten, but if you learn how to manage it correctly, you will succeed with ease.

4.    EXERCISE: I wish I discovered the helpful benefits of just how a routine of exercise  would improve my mental health and ability to concentrate when needed. It’s a well-established method to reduce stress, release endorphins,&  allows your brain to catch a break before beginning your afternoon studies/morning classes/etc.

5.    Remind yourself that YOU ARE CAPABLE. I know I’ve already stated it, but this is 10000% true. 
A fact that you need to BELIEVE- if it weren’t you wouldn’t have been accepted. Mind you, all of your classmates are in the same situation & quite honestly feeling the exact same way whether or not they express it. There are thousands of physician assistants out there- if they could do it, so can you.

6.    Stick to your Support System: Everyone needs someone to express their thoughts to if they’re struggling (in or out of school) & the reality is that WE ALL STRUGGLE. So having a supportive network of others certain you can trust to encourage you while having your best interest in mind is vital. Whether it’s someone you can count on in your class, therapist, professor, friend group, family, significant other -- find them and keep them around. Invest into their emotional wellbeing just as much as you rely on them. 
We were not created to endure tough seasons alone and no one is exempt from that reality. This profession is a tight knit community and we can only rise by lifting each other. 

If you’re still reading this & only take one thing from this post- know this: You are not alone in your feelings. If you’re struggling with anxiety / depression please contact your healthcare provider to see what may work best for you in order to overcome this period– don’t wait to take care of yourself. Your mental health is just as important as your physical health!  

XO,

      AK